Medicines for Diabetes

Many types of diabetes pills can help people with type 2 diabetes lower their blood sugar. Each type of pill helps lower blood sugar in a different way. The diabetes pill (or pills) you take is from one of these groups. You might know your pill (or pills) by a different name.

• Sulfonylureas (SUL-fah-nil-YOO-ree-ahs). Stimulates your pancreas to make more insulin.
• Biguanides (by-GWAN-ides). Decreases the amount of sugar made by your liver.
• Alpha-glucosidase inhibitors (AL-fa gloo-KOS-ih-dayss in-HIB-it-ers). Slows the absorption of starches you eat.
• Meglitinides (meh-GLIT-in-ides). Stimulates your pancreas to make more insulin.
• Thiazolidinediones (THIGH-ah-ZO-li-deen-DYE-owns). Makes you more sensitive to insulin.

Your doctor might prescribe one pill. If the pill does not lower your blood sugar, your doctor may ask you to take more of the same pills, add a new pill or insulin, or change to another pill or insulin.

These pills do two things: They help your pancreas make more insulin, and help your body use the insulin it makes to better lower your blood sugar.

Sulfonylurea medications come in a variety of generic names:

• Acetohexamide
• Chlorpropamide
• Glimepiride
• Glipizide
• Glyburide
• Tolazamide
• Tolbutamide

It also comes in a variety of brand names:

• Dymelor
• Diabinese
• Amaryl
• Glucotrol, Glucotrol XL
• DiaBeta, Glynase
• PresTab, Micronase
• Tolinase
• Orinase

For these pills to work, your pancreas has to make some insulin. Sulfonylureas can make your blood sugar too low, which is called hypoglycemia.

Some sulfonylureas work all day, so you take them only once a day. Others you take twice a day. Your doctor will tell you how many times a day you should take your diabetes pill(s). Ask if you are not sure.

When should I take sulfonylureas?

The time you take your pill depends on which pill you take and what your doctor tells you. If you take the pill once a day, you will likely take it just before the first meal of the day (breakfast). If you take the medicine twice a day, you will likely take the first pill just before your first meal, and the second pill just before the last meal of the day (supper). Take the medicine at the same times each day. Ask your doctor when you should take your pills.

The possible side effects of sulfonyluteas are hypoglycemia, upset stomach, skin rash, itching and weight gain.

Biguanides are another type of diabetes medicine. Metformin (met-FOR-min) is a biguanide that helps lower blood sugar by making sure your liver does not make too much sugar. Metformin also lowers the amount of insulin in your body.

The generic name for biguanides is metformin, while the brand name is Glucophage.

You may lose a few pounds when you start to take metformin. This weight loss can help you control your blood glucose. Metformin can also improve blood fat and cholesterol levels, which are often not normal if you have type 2 diabetes.

A good thing about metformin is that it does not cause blood sugar to get too low (hypoglycemia) when it is the only diabetes medicine you take.

You should take metformin two or three times a day. The doses should accompany meals. Your doctor should tell you which meals to take it with.

Taking metformin might make you sick if you drink more than about 2 to 4 alcoholic drinks a week. If you drink more than that, tell your doctor. You should probably not take metformin.

If you already have a kidney problem, taking metformin may make it worse. Make sure that, before you start taking metformin, your doctor knows your kidneys work well.

If you are vomiting, have diarrhea, and can't drink enough fluids, you may need to stop taking metformin for a few days.

Once in a while people on metformin can become weak, tired, or dizzy and have trouble breathing. If you ever have these problems, call your doctor or get medical help right away.

You may have nausea, diarrhea, and other stomach symptoms when you first start taking metformin. These usually go away.

You may notice a metallic taste in your mouth.

If you are going to have surgery, tell the doctor if you are taking metformin. You should be told to stop taking metformin the day of the surgery. Then you should not take metformin again until you are eating and your kidney are working normally.

If you are having a medical test with dye, tell the doctor if you are taking metformin. You may be told to stop taking metformin the day of the test and not take metformin again for 48 hours.

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